Organization
FAMILY PRACTICE ASSOCIATES OF ORANGE PARK,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE M RYAN (BILLING SPECIALIST)
(904) 264-8621
Entity
Organization
Contact information
Practice address
1594 KINGSLEY AVE, ORANGE PARK, FL 32073-4546
(904) 264-8621
Mailing address
1594 KINGSLEY AVE, ORANGE PARK, FL 32073-4546
(904) 264-8621
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
98691
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/14/2005
Last updated
07/21/2022
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